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AAPC CPC CERTIFICATION EXAM | STUDY
GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW.
TABLE OF CONTENTS
1. Fundamentals of Medical Coding (11 Questions)
2. ICD-10-CM Diagnosis Coding (15 Questions)
3. CPT Evaluation and Management Services (20 Questions)
4. CPT Surgery and Modifiers (30 Questions)
5. CPT Anesthesia, Radiology, Pathology, and Medicine (15 Questions)
6. HCPCS Level II and Compliance (9 Questions)
SECTION 1: FUNDAMENTALS OF MEDICAL CODING
Question 1: What is the primary purpose of medical coding?
A) To translate healthcare diagnoses, procedures, and services into standardized codes
B) To replace clinical documentation
C) To determine physician salaries
D) To schedule patient appointments
Correct Answer: A) To translate healthcare diagnoses, procedures, and services into
standardized codes
Medical coding translates healthcare diagnoses, procedures, and services into universal
medical alphanumeric codes. These codes are used for billing, reimbursement, statistical
analysis, and quality reporting.
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Question 2: Which code set is used to report diagnoses in the outpatient setting?
A) CPT
B) ICD-10-CM
C) HCPCS Level II
D) ICD-10-PCS
Correct Answer: B) ICD-10-CM
ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification)
is used to report diagnoses in all healthcare settings in the United States. CPT and HCPCS
are used for procedures and services. ICD-10-PCS is used for inpatient procedures.
Question 3: What does CPT stand for?
A) Current Procedural Terminology
B) Clinical Procedure Tracking
C) Certified Physician Treatment
D) Common Procedural Tool
Correct Answer: A) Current Procedural Terminology
CPT (Current Procedural Terminology) is a code set maintained by the American Medical
Association (AMA) that describes medical, surgical, and diagnostic services.
Question 4: What is the purpose of HCPCS Level II codes?
A) To report diagnoses
B) To report procedures and services not included in CPT, including supplies, drugs, and
durable medical equipment
C) To report inpatient procedures
D) To report physician E/M services
Correct Answer: B) To report procedures and services not included in CPT, including
supplies, drugs, and durable medical equipment
HCPCS Level II codes (Healthcare Common Procedure Coding System) are used to report
products, supplies, and services not included in CPT, such as ambulance services, durable
medical equipment, prosthetics, and certain drugs.
Question 5: What is the "Alphabetic Index" in the ICD-10-CM codebook used for?
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A) To find a diagnosis code by searching for the main term
B) To find a procedure code
C) To find a drug code
D) To find a modifier
Correct Answer: A) To find a diagnosis code by searching for the main term
The ICD-10-CM Alphabetic Index (Volume 2) is used to locate diagnosis codes by looking up
the main term (the condition or diagnosis) rather than the body part or procedure.
Question 6: What is the "Tabular List" in the ICD-10-CM codebook?
A) An alphabetical list of diagnoses
B) A numerical list of diagnosis codes organized by chapter and category
C) A list of procedure codes
D) A list of modifiers
Correct Answer: B) A numerical list of diagnosis codes organized by chapter and
category
The ICD-10-CM Tabular List (Volume 1) is the numerical list of diagnosis codes organized by
chapter, category, and subcategory. It includes the official guidelines and notes that must be
followed when assigning codes.
Question 7: What is the "3-year rule" in medical coding?
A) A patient is considered new if they have not received services from the provider or same
specialty within the last 3 years
B) A code can only be used for 3 years
C) A diagnosis must be documented within 3 years
D) A modifier can only be applied for 3 years
Correct Answer: A) A patient is considered new if they have not received services from
the provider or same specialty within the last 3 years
The 3-year rule defines a new patient as one who has not received any professional services
from the physician or another physician of the same specialty in the same group practice
within the previous 3 years.
Question 8: What is the "chief complaint" in medical documentation?
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A) The patient's primary reason for the visit, typically stated in the patient's own words
B) The physician's diagnosis
C) The treatment plan
D) The patient's medical history
Correct Answer: A) The patient's primary reason for the visit, typically stated in the
patient's own words
The chief complaint (CC) is the patient's primary reason for the encounter, usually stated in
the patient's own words (e.g., "I have chest pain"). It is a key component of the medical
history.
Question 9: What is the purpose of the "History of Present Illness" (HPI) in medical
documentation?
A) To describe the chief complaint
B) To document the development and progression of the patient's current illness
C) To list the patient's medications
D) To document the physical exam findings
Correct Answer: B) To document the development and progression of the patient's
current illness
The HPI describes the chief complaint in detail, including onset, location, duration,
characteristics, aggravating and alleviating factors, radiation, timing, and severity
(OLDCARTS).
Question 10: What does "ROS" stand for in medical documentation?
A) Review of Systems
B) Report of Symptoms
C) Record of Surgery
D) Results of Screening
Correct Answer: A) Review of Systems
The Review of Systems (ROS) is an inventory of body systems obtained through a series of
questions seeking to identify signs and/or symptoms that the patient may be experiencing or
has experienced. It is a key component of the medical history.
AAPC CPC CERTIFICATION EXAM | STUDY
GUIDE | LATEST UPDATE 2026/2027 |
PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW.
TABLE OF CONTENTS
1. Fundamentals of Medical Coding (11 Questions)
2. ICD-10-CM Diagnosis Coding (15 Questions)
3. CPT Evaluation and Management Services (20 Questions)
4. CPT Surgery and Modifiers (30 Questions)
5. CPT Anesthesia, Radiology, Pathology, and Medicine (15 Questions)
6. HCPCS Level II and Compliance (9 Questions)
SECTION 1: FUNDAMENTALS OF MEDICAL CODING
Question 1: What is the primary purpose of medical coding?
A) To translate healthcare diagnoses, procedures, and services into standardized codes
B) To replace clinical documentation
C) To determine physician salaries
D) To schedule patient appointments
Correct Answer: A) To translate healthcare diagnoses, procedures, and services into
standardized codes
Medical coding translates healthcare diagnoses, procedures, and services into universal
medical alphanumeric codes. These codes are used for billing, reimbursement, statistical
analysis, and quality reporting.
, Page |2
Question 2: Which code set is used to report diagnoses in the outpatient setting?
A) CPT
B) ICD-10-CM
C) HCPCS Level II
D) ICD-10-PCS
Correct Answer: B) ICD-10-CM
ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification)
is used to report diagnoses in all healthcare settings in the United States. CPT and HCPCS
are used for procedures and services. ICD-10-PCS is used for inpatient procedures.
Question 3: What does CPT stand for?
A) Current Procedural Terminology
B) Clinical Procedure Tracking
C) Certified Physician Treatment
D) Common Procedural Tool
Correct Answer: A) Current Procedural Terminology
CPT (Current Procedural Terminology) is a code set maintained by the American Medical
Association (AMA) that describes medical, surgical, and diagnostic services.
Question 4: What is the purpose of HCPCS Level II codes?
A) To report diagnoses
B) To report procedures and services not included in CPT, including supplies, drugs, and
durable medical equipment
C) To report inpatient procedures
D) To report physician E/M services
Correct Answer: B) To report procedures and services not included in CPT, including
supplies, drugs, and durable medical equipment
HCPCS Level II codes (Healthcare Common Procedure Coding System) are used to report
products, supplies, and services not included in CPT, such as ambulance services, durable
medical equipment, prosthetics, and certain drugs.
Question 5: What is the "Alphabetic Index" in the ICD-10-CM codebook used for?
, Page |3
A) To find a diagnosis code by searching for the main term
B) To find a procedure code
C) To find a drug code
D) To find a modifier
Correct Answer: A) To find a diagnosis code by searching for the main term
The ICD-10-CM Alphabetic Index (Volume 2) is used to locate diagnosis codes by looking up
the main term (the condition or diagnosis) rather than the body part or procedure.
Question 6: What is the "Tabular List" in the ICD-10-CM codebook?
A) An alphabetical list of diagnoses
B) A numerical list of diagnosis codes organized by chapter and category
C) A list of procedure codes
D) A list of modifiers
Correct Answer: B) A numerical list of diagnosis codes organized by chapter and
category
The ICD-10-CM Tabular List (Volume 1) is the numerical list of diagnosis codes organized by
chapter, category, and subcategory. It includes the official guidelines and notes that must be
followed when assigning codes.
Question 7: What is the "3-year rule" in medical coding?
A) A patient is considered new if they have not received services from the provider or same
specialty within the last 3 years
B) A code can only be used for 3 years
C) A diagnosis must be documented within 3 years
D) A modifier can only be applied for 3 years
Correct Answer: A) A patient is considered new if they have not received services from
the provider or same specialty within the last 3 years
The 3-year rule defines a new patient as one who has not received any professional services
from the physician or another physician of the same specialty in the same group practice
within the previous 3 years.
Question 8: What is the "chief complaint" in medical documentation?
, Page |4
A) The patient's primary reason for the visit, typically stated in the patient's own words
B) The physician's diagnosis
C) The treatment plan
D) The patient's medical history
Correct Answer: A) The patient's primary reason for the visit, typically stated in the
patient's own words
The chief complaint (CC) is the patient's primary reason for the encounter, usually stated in
the patient's own words (e.g., "I have chest pain"). It is a key component of the medical
history.
Question 9: What is the purpose of the "History of Present Illness" (HPI) in medical
documentation?
A) To describe the chief complaint
B) To document the development and progression of the patient's current illness
C) To list the patient's medications
D) To document the physical exam findings
Correct Answer: B) To document the development and progression of the patient's
current illness
The HPI describes the chief complaint in detail, including onset, location, duration,
characteristics, aggravating and alleviating factors, radiation, timing, and severity
(OLDCARTS).
Question 10: What does "ROS" stand for in medical documentation?
A) Review of Systems
B) Report of Symptoms
C) Record of Surgery
D) Results of Screening
Correct Answer: A) Review of Systems
The Review of Systems (ROS) is an inventory of body systems obtained through a series of
questions seeking to identify signs and/or symptoms that the patient may be experiencing or
has experienced. It is a key component of the medical history.
